{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:19:57Z","timestamp":1773285597059,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,4,20]],"date-time":"2017-04-20T00:00:00Z","timestamp":1492646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007705","name":"Astellas Pharma Global Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007705","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Invasive fungal infections are common in intensive care units (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>s) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> patients with or without documented invasive fungal infection receiving systemic antifungal therapy (<jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content>) we have performed a prospective, multicentre, observational study enrolling patients receiving <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content> in participating <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>s in Greece. During the study period, 155 patients received <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content> at 14 participating <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>s: 37 (23.9%) for proven fungal infection before treatment began, 10 (6.5%) prophylactically, 77 (49.7%) empirically and 31 (20.0%) pre\u2010emptively; 66 patients receiving early <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content> (55.9%) were subsequently confirmed to have proven infection with <jats:italic>Candida<\/jats:italic> spp. (eight while on treatment). The most frequently used antifungal drugs were echinocandins (89\/155; 57.4%), fluconazole (31\/155; 20%) and itraconazole (20\/155; 12.9%). Mean total cost per patient by <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content> strategy was \u20ac20\u00a0458 (proven), \u20ac15\u00a0054 (prophylaxis), \u20ac23\u00a0594 (empiric) and \u20ac22\u00a0184 (pre\u2010emptive). Factors associated with significantly increased cost were initial treatment failure, length of stay (<jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> before starting <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content> (i.e. from admission until treatment start), fever and proven candidaemia (all <jats:italic>P<\/jats:italic>\u2264.05). Conclusion: Early administration of antifungal drugs was not a substantial component of total hospital costs. However, there was a significant adverse impact on costs with increasing <jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content> in febrile patients in <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> for whom diagnosis of fungaemia was delayed before starting <jats:styled-content style=\"fixed-case\">SAT<\/jats:styled-content>, and with initial treatment failure. Awareness of potential candidaemia and initiation of pre\u2010emptive or empirical strategy as early appropriate treatment may improve <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> patient outcomes while reducing direct medical costs.<\/jats:p>","DOI":"10.1111\/myc.12616","type":"journal-article","created":{"date-parts":[[2017,4,20]],"date-time":"2017-04-20T09:26:38Z","timestamp":1492680398000},"page":"454-461","source":"Crossref","is-referenced-by-count":3,"title":["Clinical factors affecting costs in patients receiving systemic antifungal therapy in intensive care units in Greece: Results from the <scp>ESTIMATOR<\/scp> study"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-2648","authenticated-orcid":false,"given":"A.","family":"Armaganidis","sequence":"first","affiliation":[{"name":"Second Critical Care Department ATTIKON University Hospital National and Kapodistrian University of Athens Medical School  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Nanas","sequence":"additional","affiliation":[{"name":"First Critical Care Department General Hospital of Athens \u201cEvangelismos\u201d National and Kapodistrian University of Athens Medical School  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Antoniadou","sequence":"additional","affiliation":[{"name":"Intensive Care Unit \u201cG. 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